Ophthalmic Pathology Rotation for Ophthalmology Residents
Overview. The resident will participate in all aspects of the diagnostic and educational Ophthalmic Pathology service. On an annual basis, the service handles 275-300 PUH/Eye and Ear cases/year and 35-50 consults/year from tri-state area adult and pediatric hospitals and the coroners office, including 60-70 enucleations/year. One of the unique opportunities in this rotation is the opportunity for training in gross and microscopic assessment of eyeballs removed for tumors, trauma, child abuse, end-stage medical disorders such as glaucoma, and developmental anomalies. An extensive collection of self-study material is available in the Eye Pathology Suite of 826 EEI. Opportunities preparing case reports are also available on an individualized basis.
Goals
1.) Gain familiarity with the normal appearance of ocular structures submitted to Pathology and their relationship to visual function
2.) Learn to identify, orient, and systematically examine enucleation specimens, when available
3.) Provide an overview of major pathologic reactions of the eye through reading assignments, quizzes, and examination of pathologic case material. For example:
*Be able to identify diagnostic features of FuchsÕ dystrophy and keratoconus, and to discuss
causes of bullous keratopathy.
*Be able to discuss the role of PAS, Congo red, Alcian blue and other stains in ophthalmic pathology.
*Be able to discuss pathologic features of prognostic significance in ocular melanomas
*Be able to discuss three types of common eyelid neoplasms
*Learn to recognize sequelae of diabetes, end-stage glaucoma, and trauma including child abuse.
On own time, but BEFORE conference on Tuesday Ð Read weekly assignment and take quiz.
Tuesdays from 1:00-1:15 Ð Organize paperwork and slides for all cases. Make sure all cases are accounted for. Becky Byles will provide case list for the week on Monday morning along with pathology dictations in box in A509. On the list, for all highlighted cases, indicate if slides are present, if case needs gross examination (eyeballs), or if the case is gross-only.
Tuesdays from 1:15-2:30 pm. Gross enucleation conference, A507
After the first one or two eyeballs, you will be expected to identify, orient and perform the external exam on all enucleations independently by 1:35. Graduated responsibility in learning how to cut and photodocument the gross pathology will follow.
Tuesdays from ~2:30-4 pm (or immediately following Gross conference). Microscopic signout. Cases will be reviewed and final diagnoses issued. Quizzes will be discussed and questions answered.
On own time Tuesday-Wednesday Ð Obtain additional clinical followup information and/or notify Dr. Chu of your attempts to do so by Wednesday at 4 pm.
Thursday Ophthalmic Pathology lectures, EEI Board Room (when scheduled)
¥Be on time or call ahead if emergency comes up.
¥Remember to coordinate dates of vacation or cross coverage in advance so that we can coordinate the weekly reading assignments and quizzes.
¥Pre-viewing slides for cases before signout and writing down your own histologic observations and diagnostic impression is strongly recommended. All slides and dictation paperwork are placed in the boxes in A509 as they come in over the week. Please feel free to stop by when you have 10-15 minutes during the week.